Why does a chocolate cyst cause infertility?

Written by Zhang Lu
Obstetrics
Updated on April 03, 2025
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Chocolate cysts, also known as ovarian endometriomas, are a manifestation of endometriosis. Generally, it refers to the implantation of endometrial tissue on the ovaries, causing local infiltration and invasion, leading to cysts. Because the fluid inside the cyst resembles chocolate, they are called chocolate cysts. Chocolate cysts may cause infertility, for the following reasons: First, chocolate cysts can affect the function of the ovaries, causing ovulatory disorders and ovarian dysfunction. The secretion of estrogen and progesterone is relatively low, and these factors can lead to infertility. Second, chocolate cysts can cause adhesions within the pelvic cavity, affecting the egg-picking function of the fallopian tubes. This factor can also lead to female infertility.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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What are the tests for infertility?

For infertility examinations, men typically undergo a routine semen analysis to check for any abnormalities. If there are abnormalities in the semen analysis, further testing might be needed for conditions such as varicocele or inflammation of the testicles and epididymis. For women, the examinations generally focus on the fallopian tubes to ensure they are patent, usually assessed through hysterosalpingography or a tubal patency test. Additionally, infertility tests include an ultrasound to monitor the follicles and check for any organic diseases in the uterus and ovaries. For women with menstrual irregularities, it's crucial to perform an endocrine test, specifically the six-item sex hormone check, as normal hormonal levels are necessary for regular menstruation and ovulation, and for the normal development of a fertilized egg. Other investigations for infertility might cover immune-related infertility among others, which require specific hospital tests. Moreover, if there has been a previous incidence of miscarriage, tests might include chromosomal analysis, tests for hemolysis, mycoplasma testing, and a set of tests for genetic counseling, all of which are part of the infertility examination process.

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Written by Luo Chun Yan
Obstetrics and Gynecology
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Does taking emergency contraceptive pills cause infertility?

If emergency contraception is only used occasionally, it generally has a minor impact on fertility. However, frequent use of emergency contraceptives may lead to infertility. Emergency contraception usually consists of a combination of estrogen and progestin, with a high hormonal content. Its primary functions are to alter cervical mucus viscosity, hinder sperm mobility, suppress ovulation, and modify the endometrial environment in the uterus, thereby providing a contraceptive effect. Some may cause menstrual irregularities or ovulation disorders, affecting the motility of the fallopian tubes, potentially leading to ectopic pregnancies, which can cause infertility. Thus, emergency contraception should not be used as a regular method of contraception.

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Written by Kang Jian Hua
Reproductive Center
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Treatment methods for infertility

The main treatment methods for infertility include medication, surgical treatment, and assisted reproductive technologies. Medication can target endocrine abnormalities and reproductive tract infections in both males and females. Surgical treatment can be aimed at conditions such as varicocele in males and uterine fibroids and ovarian cysts in females. Assisted reproductive technologies primarily address severe oligospermia in males and tubal blockages in females, among other common diseases. It is recommended to visit the reproductive medicine department of a local public hospital to clarify the cause of infertility and receive targeted treatment. (Specific medications should be taken under the guidance of a doctor.)

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Written by Kang Jian Hua
Reproductive Center
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How to cure immune infertility

Immune infertility comes in many forms, such as anti-sperm antibody positivity and anti-endometrial antibody positivity, among others. The treatment for immune infertility commonly involves the use of isolating therapy, which entails using a condom during sexual intercourse. After using this method for three to six months, it can reduce further stimulation of the female by the sperm antigen, and once the antibody effect has dissipated, intercourse is timed with ovulation. At this time, conception is often possible. For immune infertility, some may choose intrauterine artificial insemination depending on the situation, which involves processing and separating the husband's semen outside the body to extract high-quality sperm for intrauterine insemination. Another method is anti-immune therapy, but the medications often have adverse side effects on the body.

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Written by Kang Jian Hua
Reproductive Center
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Can immunological infertility be treated?

Immunological infertility is treatable. There are several main methods for treating immunological infertility. The first method is the blocking therapy, which involves using condoms for 3-6 months to make the sperm antigen antibodies disappear, thereby increasing the conception rate through alternate day intercourse. Many women are able to conceive through this method. The second method is in vitro fertilization, which is chosen if there is a high density of antisperm antibodies in the woman's body, making in vitro fertilization necessary for conception. This method generally has a high success rate. The third method is intrauterine artificial insemination. When there are many antisperm antibodies in the woman’s cervical mucus, this method involves treating the male’s semen outside the body, selecting high-quality sperm for artificial insemination. The fourth method is immunosuppressive therapy, which primarily involves the use of corticosteroids. However, the use of these hormones often causes some adverse damage to the body.